Active Lifestyle Research Articles

Modifiable lifestyle factors in the primordial prevention of hypertension in three US cohorts

Background: Evidence is lacking on the relative contributions of specific lifestyle factors and their overall contribution to prevention of hypertension, in particular early-onset hypertension. Methods: This prospective cohort study included participants of the Nurses’ Health Study (NHS, N=52,780 women, aged 40–67 in 1986), the NHS II (N=83,871 women, aged 27–46 in 1991), and the Health Professionals Follow-up Study (HPFS, N =31,269 men, aged 40–75 in 1986), who were free from hypertension, cardiovascular disease and cancer at baseline. Four modifiable lifestyles were evaluated based on hypertension guidelines: BMI, moderate-to-vigorous physical activity, Dietary Approaches to Stop Hypertension (DASH) score, and alcohol intake. Primary outcome was incident self-reported diagnosis of hypertension with 27-31 years of follow-up. Results: Each lifestyle factor was associated with incident hypertension in dose-dependent manners across the cohorts, with BMI having the strongest associations. On average, adhering to BMI <25 kg/m2 was associated with 20.3 [18.5, 22.0], 25.0 [23.2, 26.8], and 18.6 [16.7, 20.7] months longer periods free from hypertension during 25-year follow-up in each cohort respectively. BMI accounted for approximately 20% of incident hypertension in NHS and HPFS, and 35% of early-onset hypertension (age < 55y). Moderate-to-vigorous physical activity and diet accounted for 10-15% of incident hypertension in women, and the contributions were greater for early-onset hypertension. Conclusion: Healthy weight during adulthood was most substantially associated with incident hypertension among lifestyle factors, but diet, physical activity, and alcohol intake were also related to the risk across all ages, and hypertension-free periods, with stronger associations in early-onset hypertension.

Motivation towards physical activities among Malaysian population by gender and age group

Sports culture among Malaysia Population still lacking and the percentage of inactive people still high and increase since year 2018. The aim of this study is to determine the level and influence of motivation towards physical activities based on gender and age groups. The researchers employed a survey design involving 7,015 respondents aged 13 years and above. Sampling selection across Malaysia was facilitated by Department of Statistic Malaysia based on block calculation and residence area from 13 states and 3 Federal Territories. The researcher employed the Multistage Cluster sampling random strategy by combining the cluster sampling procedure with stratified random sampling. A questionnaire designed by IYRES with high validity (r = 0.95) and reliability (r = .96) employed for data collection. A total of 190 trained enumerators collects the data manually. The findings of the analysis through an independent sample t-test showed that mean score for Males (M = 31.94, SD = 10.70) and for females (M = 29.84, SD = 10.82). p = .000, is significant. The results showed that there were significant differences in the mean of motivation towards physical activity participation between male and female respondents. Comparison by age group using One-way ANOVA showed that there were significant differences in the motivation of involvement in physical activity between the age groups, p = 0.000. Group pre-youth (M = 30.39, SD = 9.56), youth (M = 32.78, SD = 10.06), post youth (M = 30.72, SD = 11.06) and senior citizen 60 years and above (M = 26.76, SD = 10.72). This outcome proves that age does influence motivational factors in physical activity participation. The motivation level among youth is the highest and the elderly above 60 years old the lowest. Motivational factors are influenced by gender and age group in complex ways. Women tend to be more motivated by intrinsic factors such as job satisfaction, relationships, and personal growth, while men often lean towards extrinsic rewards. Younger individuals may be more driven by extrinsic rewards such as prizes, recognition, free gifts and performance achievements. Overall, psychological factors play a critical role in shaping individuals’ attitudes, beliefs, motivations, and behaviors regarding physical activity. By addressing psychological barriers and leveraging motivational strategies, interventions can effectively promote participation in exercise and support individuals in adopting healthier and more active lifestyles.

Associations between family factors and physical activity clustering in preschool children: a cross-sectional study.

This study aimed to examine the association between family factors and physical activity (PA) clustering in preschool children. Preschoolers' PA and sedentary behavior (SB) were assessed consecutively for 7 days using ActiGraph accelerometers based on the cutoff counts developed by Pate et al. Information about children, their parents, and their families was collected using questionnaires. We developed a two-step approach to clustering PA both inside and outside of kindergarten. The Euclidean distance metric was utilized to distinguish between groups, while the Schwarz-Bayesian criterion was applied to identify the most optimal sub-group model. A one-way ANOVA was used to assess the clustering effect, and logistic regression was used to analyze the influencing factors of different clustering. We collected data from 291 preschool children aged 3 to 6 years and divided them into three clusters-Inactive (50.2%), Active in kindergarten (26.8%), and Active outside kindergarten (23.0%)-with significant differences in PA and SB, revealing distinct temporal and spatial clustering patterns (silhouette coefficient = 0.3, p < 0.05). Furthermore, preschooler activity levels correlated significantly with factors including gender (OR = 0.35, 95% CI: 0.19-0.66), age (OR = 1.05, 95% CI: 1.00-1.10), birth weight (OR = 1.79, 95% CI: 1.16-2.76), paternal age (OR = 1.01, 95% CI: 1.00-1.02), and maternal income (OR = 0.68, 95% CI: 0.48-0.96). This study shows that the family environment or parents significantly influence the PA of preschool children. Older fathers may promote preschool children's PA through greater educational focus and financial stability, while higher maternal income can provide more opportunities and resources for preschool children to engage in active lifestyles. Thus, it is suggested that families providing more attention and exercise opportunities for preschool children's education can help improve their PA levels in the future.

Vascular occlusion for optimising the functional improvement in patients with knee osteoarthritis: a randomised controlled trial.

Knee osteoarthritis (KOA) is a leading cause of global disability with conventional exercise yielding only modest improvements. Here we aimed to investigate the benefits of integrating blood flow restriction (BFR) into traditional exercise programmes to enhance treatment outcomes. The Vascular Occlusion for optimizing the Functional Improvement in patients with Knee Osteoarthritis randomised controlled trial enrolled 120 patients with KOA at Ghent University Hospital, randomly assigning them to either a traditional exercise programme or a BFR-enhanced programme over 24 sessions in 12 weeks. Assessments were conducted at baseline, 6 weeks, 12 weeks and 3 months postintervention using linear mixed models with Dunn-Sidak corrections for multiple comparisons. Primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire at 3 months follow-up with knee strength, Pain Catastrophizing Scale questionnaire and functional tests as secondary outcomes. Analysis followed an intention-to-treat approach (NCT04996680). The BFR group showed greater improvements in KOOS pain subscale (effect size (ES)=0.58; p=0.0009), quadriceps strength (ES=0.81; p<0.0001) and functional tests compared with the control group at 12 weeks. At 3 months follow-up, the BFR group continued to exhibit superior improvements in KOOS pain (ES=0.55; p=0.0008), symptoms (ES=0.59; p=0.0004) and quality of life (QoL) (ES=0.66; p=0.0001) with sustained benefits in secondary outcomes. Drop-out rates were similar in both groups. Incorporating BFR into traditional exercise programmes significantly enhances short-term and long-term outcomes for patients with KOA demonstrating persistent improvements in pain, symptoms, QoL and functional measures compared with conventional exercise alone. These findings suggest that BFR can provide the metabolic stimulus needed to achieve muscle strength and functional gains with lower mechanical loads. Reduced pain and increased strength support a more active lifestyle, potentially maintaining muscle mass, functionality and QoL even beyond the supervised intervention period. NCT04996680.

Evaluating the Effects of an 8-Week Zumba Exercise Program on Physical Fitness in Sedentary Women: A Randomized Controlled Trial

Objectives. This study aimed to evaluate the impact of an 8-week Zumba exercise program on physical fitness and body composition among sedentary women. The primary goals were to assess changes in muscle mass, flexibility, back strength, cardiovascular fitness, body weight, and body fat percentage. Materials and methods. Twenty-four female volunteers (mean age: 22.30 ± 2.10 years, height: 162.80 ± 4.00 cm) from North India were randomly assigned to either an experimental group, participating in a structured Zumba program (60-minute sessions, thrice weekly), or a control group, maintaining their usual activities. The initial and follow-up assessments comprised the measurement of height, weight, Body Fat Percentage (BFP), Body Muscle Mass (BMM), grip strength, back strength, flexibility, and Maximal Oxygen Consumption (VO₂max). Results. The statistical analysis conducted using the SPSS 26 software and the Wilcoxon Signed-Rank Test revealed significant improvements in the experimental group. Body weight decreased from 58.20 ± 5.10 kg to 56.80 ± 5.00 kg (p = 0.002), body fat percentage dropped from 25.10 ± 5.80% to 23.80 ± 6.00% (p = 0.03), and body muscle mass increased from 20.40 ± 3.20 kg to 21.00 ± 3.30 kg (p = 0.04). Grip strength improved from 32.50 ± 5.00 kg to 33.20 ± 4.80 kg (p = 0.05), back strength rose from 85.00 ± 22.00 kg to 105.00 ± 25.00 kg (p = 0.001), flexibility increased from 31.00 ± 2.80 cm to 34.00 ± 2.50 cm (p = 0.002), and VO₂Max increased from 41.00 ± 5.00 ml/kg/min to 44.00 ± 4.50 ml/kg/min (p = 0.001). No significant changes were observed in the control group. Conclusions. The 8-week Zumba program significantly enhanced physical fitness and body composition in sedentary women, improving muscle mass, flexibility, back strength, and cardiovascular fitness. These findings support Zumba as an effective and enjoyable exercise option, promoting an active lifestyle and better health outcomes, reinforcing its role as a comprehensive fitness solution suitable for encouraging sustained physical activity.

Product Development and Positioning Strategies for Seaclues Local Coffee

Seacules Coffee Shop uses psychographic, demographic, and behavioral factors to segment the market. Seaclues Coffee Shop's target market includes consumers between the ages of 18 and 45 who lead an active lifestyle and work as professionals or students. Seaclues Coffee Shop's goods are presented as premium coffee beverages. Seaclues serves high-quality coffee beans that have been roasted by a roaster. Coffee is served to customers with high quality services provided in a comfortable atmosphere. By implementing the right positioning strategy, Seaclues Coffee Shop can attract and retain the right customers, increase customer satisfaction, and build long-term loyalty. To respond to the dynamic market, Seaclues Coffee Shop has carried out product development by creating unique and high quality product variants. The quality of Seaclues coffee products comes from high quality coffee beans that go through a roasting process before being processed for serving. Seaclues Coffee Shop develops innovative and unique coffee products by utilizing spices. Accurate positioning and product development help Seaclues Coffee Shop create quality products that are different from competitors, which strengthens Seaclues Coffee Shop's presence in a competitive market.

Device-measured vigorous intermittent lifestyle physical activity (VILPA) and major adverse cardiovascular events: evidence of sex differences.

Vigorous intermittent lifestyle physical activity (VILPA) refers to brief bouts of intense physical activity embedded into daily life. To examine sex differences in the dose-response association of VILPA with major adverse cardiovascular events (MACE) and its subtypes. Using multivariable-adjusted cubic splines, we examined the associations of daily VILPA duration with overall MACE and its subtypes (incident myocardial infarction, heart failure and stroke) among non-exercisers (individuals self-reporting no leisure-time exercise and no more than one recreational walk per week) in the UK Biobank. We also undertook analogous analyses for vigorous physical activity among exercisers (individuals self-reporting participation in leisure-time exercise and/or recreational walking more than once a week). Among 13 018 women and 9350 men, there were 331 and 488 all MACE, respectively, over a 7.9-year follow-up. In women, daily VILPA duration exhibited a near-linear dose-response association with all MACE, myocardial infarction and heart failure. In men, dose-reponse curves were less clear with less evidence of statistical signifigance. Compared with women with no VILPA, women's median daily VILPA duration of 3.4 min was associated with hazard ratios (HRs; 95% confidence intervals) of 0.55 (0.41 to 0.75) for all MACE and 0.33 (0.18 to 0.59) for heart failure. Women's minimum doses of 1.2-1.6 min of VILPA per day were associated with HRs of 0.70 (0.58 to 0.86) for all MACE, 0.67 (0.50 to 0.91) for myocardial infarction, and 0.60 (0.45 to 0.81) for heart failure. The equivalent analyses in UK Biobank's accelerometry sub-study exercisers suggested no appreciable sex differences in dose-response. Among non-exercising women, small amounts of VILPA were associated with a substantially lower risk of all MACE, myocardial infarction and heart failure. VILPA may be a promising physical activity target for cardiovascular disease prevention, particularly in women unable or not willing to engage in formal exercise.

Identity in the context of physical activity and smoking: A scoping review among adults aged 45+

Abstract Background Identity (i.e., self-perceptions of oneself) plays an important role in health behaviors such as physical activity (PA) and smoking. This review offers a comprehensive synthesis and comparison of how PA- and smoking-related identity is associated with PA and smoking behavior in adults aged 45+. It further synthesizes and compares identity terminology and measurement tools used to capture identity concerning smoking cessation and PA among adults aged 45+. Where applicable, the role of personal, PA-, and smoking-related characteristics were considered. Methods A thorough search across 11 databases, updated in May 2023, yielded 5801 unique publications. Ensuing careful screening procedures, 45 peer-reviewed empirical studies were systematically reviewed. Experts in the field contributed to validate and structure the narrative. Results The review reveals a complex, enduring connection between identity and behavior in both PA and smoking domains, encompassing processes like identity formation, maintenance, change, and loss. In essence, identities linked to PA and abstaining from smoking emerged as pivotal for promoting active lifestyles and successful smoking cessation. Many parallels but also distinctions emerged within this association, alongside variations in the terminology and measurement tools pertaining to identity. Factors such as gender, age, and behavioral history emerged as influential in shaping identities related to smoking and PA. Conclusions Despite variances, findings suggest that the relationship between identity and behavior, including associated processes, may not fundamentally differ between health-promoting and health-compromising behaviors. There is however need for more unified identity definitions and measurement tools. We propose avenues for future research, including exploring causality between identity and behavior to facilitate the development of identity-related smoking cessation and PA-promotion interventions. Key messages • Identities associated with physical activity and refraining from smoking are associated with a physically active lifestyle and successful smoking cessation. • Despite differences, the relationship between identity and behavior may not fundamentally vary between health-promoting and health-compromising behaviors.

A Multi-Modal Approach for A Healthier Weight and More Active Lifestyle

Abstract Background Obesity and overweight has been increasing globally and in the UK over the last few years, bringing along a wide array of challenges in health and wellbeing. Not only do they take a heavy toll on those affected, but obesity and overweight-related ill-health is costing the UK National Health Service £6.1 with projected costs to run up to £9.7 billion in 2050. This project aimed to apply artificial intelligence to identify the predictive indicators for obesity and co-create an intervention with public health practitioners and stakeholders. Methods Using health and wellbeing public health population data from the 2015, 2018 and 2022 from a city in the East Midlands, we applied artificial intelligence that uses machine learning techniques to discover insights, find hidden patterns and discover relationships in the data about engaging in physical activity and a healthy diet. The data on dietary choices and physical activity preferences were further analysed using advanced machine learning techniques. Results The outcomes from our machine learning process revealed patterns of physical activity engagement and diet from specific locations, along with a range of demographic variables that influence individuals’ patterns of physical ability and dietary practices. These findings, which will be presented in detail, have been integrated into a comprehensive city map. This map not only showcases opportunities for engaging in a healthy lifestyle but also aids in prioritising interventions in areas of greatest need. Conclusions The AI technology we employed allowed us to parameterise and generalise our findings with the possibility of scaling up the machine learning approach to other similar datasets. The findings facilitated the development of bespoke training for public health officers working with underserved communities, further demonstrating the impact of applying AI to inform the design of public health interventions. Key messages • Applying Artificial Intelligence to public health data has the potential to inform the development of effective interventions and increase precision. • Using AI in public health data can generate new insights into population health and well-being and inform public health policy.

Built environmental characteristics, physical activity in neighbourhoods of Accra, Ghana

Abstract There is increasing evidence that characteristics of the built environment can influence residents’ lifestyles, physical activity thereby influencing the development of obesity and non-communicable diseases even in low- and middle-income countries. The aim of this study is to describe the characteristics of the built and the social environment of neighbourhoods of Accra, Ghana, and to explore association between neighbourhood characteristics and the physical activity of the residents. A cross-sectional study was conducted in Accra, 12 neighbourhoods were randomly selected based on high and low values of residential density and socioeconomic status. Sociodemographic, household and neighbourhood information were collected with an adapted questionnaire of NEWS (Neighbourhood Environment Walkability Scale) for Africa. Physical activity was assessed by WHO Global Physical Activity Questionnaire and social cohesion by the Perceived Neighbourhood Social Cohesion Questionnaire. Differences between variables by neighbourhood types were analysed using Chi square test and Kruskal Wallis test. Generalized linear model was performed to determine the association between neighbourhood characteristics and residents’ physical activity. The built environmental characteristics of different neighbourhood types and the physical activity of the residents showed significant differences. The associations indicated that individuals living in high residential density neighbourhoods had increased levels of engaging in physical activities. Land use mix, street connectivity, safety, aesthetics and social cohesion of neighbourhoods showed correlation with physical activity of residents. The built environment and social characteristics of neighbourhoods can influence the lifestyle and physical activity of residents in Accra, Ghana. Key messages • High residential density neighbourhoods correlated with higher level of physical activity. • Land use, street connectivity, safety and aesthetic of neighbourhoods and social cohesion showed correlation with physical activity.

Endothelial dysfunction in acute coronary syndrome: a complex association with cardiovascular risk factors, sleep quality and cardiorespiratory capacity

Abstract Introduction It is widely acknowledged that normal endothelial function plays a pivotal role in conferring cardioprotective effects against ischemia-reperfusion injury following acute myocardial infarction (AMI) treated by a primary percutaneous coronary intervention (PCI), thereby limiting infarct size (1). However, endothelial dysfunction (ED) has been extensively documented in patients with cardiovascular (CV) risk factors (2). This study proposes a novel perspective, positing that ED could be intricately linked not only with traditional CV risk factors, but also it can be associated with poor sleep quality. Consequently, this interplay might significantly contribute to the attenuation of exercise capacity. Objective The aim of this study was to assess endothelial function following AMI treated with a PCI and investigate the link between endothelial function, CV risk factors, sleep quality and exercise capacity. Furthermore, the study aimed to determine if endothelial function could serve as a predictive factor for future major adverse acute cardiac events (MAACE) following AMI. Materials and methods Sixty-three patients with AMI (56.21 ± 7.6 years) volunteered to participate in this study, . Endothelial function was assessed using the Endothelium Quality Index (EQI) . Sleep quality was evaluated using both actigraphy and the PSQI (Pittsburgh Sleep Quality Index) questionnaire. Exercise capacity was quantified through the 6-minute walking test (6mwt). Results ED was evident, as indicated by an EQI of 1.4 ± 0.7. Furthermore, ED was notably influenced by CV risk factors such as low physical activity level, age, and smoking. A significant correlation was found between EQI and both sleep efficiency (r = 0.340; p = 0.006) and PSQI score (r = -0.533; p &amp;lt; 0.001). Additionally, a strong association was observed between endothelial function and the results of the 6mwt (r = 0.291; p = 0.021). Furthermore, during a follow up period ( near 4 months) following PCI, MAACE were observed in patients with severe ED only. Conclusion In summary, findings of this study may emphasize the importance of enhancing sleep quality and advocating for an active lifestyle as modifiable elements to enhance endothelial function, which can be regarded as a prognostic tool subsequent to AMI, ultimately contributing to improved clinical outcomes. Moreover, this study concluded that AMI patients with severe endothelial dysfunction were more likely to develop MAACE.Endothelial Dysfunction after AMIED following AMI : Causes and effect

Agricultural activities reduce the risk of requiring long-term care among older Japanese

Abstract Introduction Controlling the risks that lead to requiring long-term care for the older adults is a crucial medical and socio-economic issue. This study investigated the impact of agricultural activities (AAs) on the risk of requiring long-term care. Methods A 5-year follow-up was conducted on 1,009 healthy individuals aged 65-80 years (mean age 72 years; 44% men) living in a rural area (Wakayama, Japan). Requiring long-term care was assessed as requiring support or nursing care (RSNC) according to the Japanese criteria. Health status including frailty and metabolic syndrome were also assessed using Japanese criteria. Work status and lifestyle habits were assessed using self-administered questionnaires. The main outcome was the probability of RSNC. COX proportional hazards regressions were performed, stratified by occupation (agricultural worker or other) or frequency of AAs (none, less than or &amp;gt;150 days/year), adjusted for sex, age, frailty, metabolic syndrome and household as possible confounding factors. Results Approximately 35% of the participants were in agriculture, forestry, and fisheries as occupation, and 78% engaged in AAs. A total of 85 participants RSNC and 39 deaths were observed during the follow-up. The cumulative survival probability did not differ according to occupation or frequency of AAs, whereas the probability of RSNC was significantly lower in participants engaged in AAs (hazard ratio 0.37 [95% CI 0.22, 0.62]; &amp;lt;150 days/year, 0.29 [95% CI 0.17, 0.50]; &amp;gt;150 days/year). Participants engaged in AAs were significantly more likely to engage in low- and vigorous-intensity physical activity, and to participate in industry and community organizations and relating events. Conclusions These findings suggest that AAs may promote a physically and socially active lifestyle, independent of frailty or metabolic syndrome, and reduce the risk of RSNC. Key messages • Prevention of long-term care is important in the older population. • A lifestyle associated with agricultural activities may contribute to healthy aging.

Association between wearable activity trackers usage and levels of physical activity among Athens Medical Society members

Abstract Introduction Wearable Activity Trackers (WAT) provide real-time feedback on activity levels and play a pivotal role in fostering an active lifestyle. Moreover, WAT can encourage doctors’ awareness to be more conscious of their daily physical activity whose exercise habits range between different medical specialties. Purpose The aim of this study is to evaluate the influence of WAT usage on physicians’ exercise habits according to the recommendations of ESC Guidelines. Methods This cross-sectional study comprised 742 physicians of the Athens Medical Society (AMS), Greece. The study instrument was a self-administered questionnaire mailed in October 2023 to evaluate physicians’ usage of WAT, baseline characteristics of population, specialty, and physical exercise habits. European Society of Cardiology (ESC) Guidelines recommend at least 150 min/week of moderate-intensity exercise in all healthy adults. Subjects were divided in two groups according to their usage of WAT or not in their everyday life: 1. Daily usage of WAT (Group A); 2. No regular or even on usage of WAT (Group B). Results A considerably high proportion of the total population use WAT daily (38%). Between Group A and Group B there was no difference in age (49±12 years vs. 51±13 years, p=0.07), male sex prevalence (55% vs. 49%, p=0.08) and BMI (25.7± 4.6 kg/m2 vs. 25.2± 4.1 kg/m2, p=0.11). Interestingly, there was statistically significant difference in mean exercise endurance training time between Group A and Group B (301±304 min. vs. 209±268 min., p&amp;lt;0.001) (Figure 1) and in the proportion of the doctors who follow the ESC Recommendations (63.5% vs. 47.2%, p&amp;lt;0.001). Furthermore, most of the physicians who use WAT have awareness for ESC Guidelines (59% vs. 47%, p&amp;lt;0.001), and most of them apply diet to lose weight (36% vs. 29%, p=0.04). Finally, WAT were mostly used by 4 main specialties: Cardiology (47%), Endocrinology (44%), Surgery (35%) and Internal Medicine (25%), with cardiologists reporting the higher use (p=0.045). Conclusion This study underscores the widespread adoption of WAT among physicians, highlighting their potential to positively influence exercise habits and adherence to ESC Guidelines. Physicians using WAT demonstrated increased exercise endurance training time, greater awareness of ESC Guidelines, and a higher propensity to implement weight loss diets compared to non-users. Additionally, variations in WAT usage and awareness of ESC Guidelines across medical specialties emphasize the need for targeted interventions to promote physical activity and enhance overall health among healthcare professionals.

Quality of life and adherence to healthy lifestyle factors among breast cancer survivors in Cyprus

Abstract Breast cancer is a prevalent disease for women globally, with rising survival rates highlighting the need to address the breast cancer survivors’ (BCS) quality of Life (QoL). Furthermore, adherence to a healthy lifestyle is associated with decreased mortality in BCS. Mapping the Lifestyle Medicine pillars and the World Cancer Research Fund/American Institute for Cancer Research recommendations identifies 7 healthy lifestyle components: weight management, physical activity, healthy eating, restorative sleep, avoidance of risky substances, positive social connections and stress management. This study examines adherence to these healthy lifestyle components and QoL among BCS. A cross-sectional study conducted in 2022-23 recruited primary adult BCS from the Bank of Cyprus Oncology Centre. Participants completed a survey assessing self-reported QoL and adherence to the aforementioned 7 healthy lifestyle components, through validated questionnaires. Out of 349 BCS approached, 272 were included in the final analysis. Mean age and time since main treatment completion were 51 (SD: 7.4) and 3.6 (SD: 2.5) years respectively. Amongst study participants 58% were classified as bad sleepers, 53.3% were overweight or obese, 23% were stressed, 78% reported to have moderate/high physical activity, and 60% adhered to the Mediterranean diet. Regarding substance use, 16% were current smokers, and 18% were hazardous drinkers. Median score for social support was 75 (IQR: 53-97; max score=100) and for QoL was 67 (IQR: 50-97; max score:100). BCS in Cyprus generally exhibit moderate adherence to the Mediterranean diet, engage in fairly active lifestyles and enjoy high levels of social support and QoL. On the other hand, a substantial proportion smoke or drink, are overweight or obese, are stressed and have poor sleep quality. Targeted interventions to increase the adherence of breast cancer survivors to the 7 healthy lifestyle components are required. Key messages • Overall variability exists in the adherence to healthy lifestyle components among BCS in Cyprus. • This population can benefit from intervention targeting sleep, stress and weight management.

Correlates of using behavioural sciences to design health promotion interventions and programs

Abstract Background The World Health Organization highlighted the need to better integrate behavioural science in the field of public health. Based on the theoretical domains framework, this study examined correlates of public health practitioners’ use of behavioural science principles to plan public health actions aim at promoting physical activity and healthy eating. Methods This study adopted a cross-sectional design. A convenience sample of 160 public health practitioners were recruited from different public health agencies (non-profit organizations, governmental and para-governmental agencies). They were asked to complete a survey questionnaire online and self-reported their use of behavioural science to plan health promotion interventions. Regression analyses were conducted to examine correlates of behaviour and behavioural intentions. All analyses were controlled for sex, number of years of experience in public health and the type of organization they work for. Results Skills (OR = 4.1, 95%CI: 1.3, 13.5) and intentions/goals (OR = 9.2, 95%CI: 2.3, 36.1) were the two domains significantly associated with the use of behavioural science. Perceived capacity to overcome the fact that none of their colleagues rely on behavioural sciences in their organization (OR = 7.2, 95%CI: 1.7, 30.3) was also associated with behaviour. Knowledge (OR = 8.6, 95%CI: 1.9, 39.1) and beliefs about consequences (OR = 4.0, 95%CI: 1.1, 14.7) were in turn associated with intentions/goals. Conclusions This unique study provides important insights for the development of future knowledge transfer activities aim at supporting positive attitudes and motivations toward the use of behavioural science as well as developing competencies and a normative use of behavioural science. The development of a strong knowledge basis would also need to be a core component of trainings to support the integration of behavioural science in public health to design physical active lifestyles and healthy eating interventions. Key messages • Increasing knowledge and skills in behavioural sciences is a key for a better integration in public health practices. • Changes in norms and attitudes toward the use of behavioural sciences will also support a better uptake.

Correlation The Level of Nutritional Knowledge, Breakfast Consumption Patterns With Nutritional Status of Age Students 10-12 MI Dakwatul Khoiriyah Kediri

Children aged 10–12 years need significant energy due to their rapid growth and active lifestyles. Their nutritional status is influenced by nutritional knowledge and breakfast habits. To examine the relationship between nutritional knowledge, breakfast habits, and nutritional status of students aged 10–12 years at MI Dakwatul Khoiriyah Kediri. A cross-sectional study with 40 students using questionnaires for nutritional knowledge, SQ-FFQ interviews to evaluate breakfast habits, and BMI for age index to determine nutritional status. Spearman correlation tests were used for analysis. The study found that 62.5% had low nutritional knowledge, 60% had infrequent breakfast habits, and 65% were malnourished. There is a significant relationship between the level of nutritional knowledge and nutritional status (p=0.000, r=0.688) and between the habit of rarely eating breakfast and poor nutritional status (p=0.000, r=0.812). There is a significant relationship between nutritional knowledge, breakfast habits, and nutritional status of students aged 10–12 years at MI Dakwatul Khoiriyah Kediri. Students should have daily breakfast to meet nutritional needs and improve nutritional status.

Analysis of Biological Factors Associated with Preeclampsia in Pregnant Women

Preeclampsia is a serious complication during pregnancy that poses significant health risks to both mother and fetus, potentially leading to death. Early identification of biological factors associated with preeclampsia is crucial for effective prevention. This study aims to analyze the biological factors influencing preeclampsia incidence among pregnant women. A quantitative design with a case-control approach was used, focusing on pregnant women with a history of preeclampsia in the Curug Community Health Center, Karawang Regency. The sample included 10 respondents. The results revealed a significant relationship between parity and preeclampsia incidence (p-value 0.031), BMI (p-value 0.018), diet (p-value 0.041), and history of complications (p-value 0.001). However, no significant association was found between lifestyle activities and preeclampsia (p-value 0.114). These findings suggest that factors like parity, BMI, diet, and complications history are significantly linked to preeclampsia incidence. These results provide a basis for targeted interventions in pregnant women's care. Future studies should expand the sample size and consider additional variables such as employment status, family support, and stress levels for more comprehensive insights into preeclampsia risk factors.

Parenting Practices to Prevent Childhood Obesity Among Hispanic Families: A Systematic Literature Review.

Background: Childhood obesity disproportionately affects Hispanic families and remains an unresolved public health concern. Interventions to enhance health-related parenting practices may be a promising strategy to lower the risk for childhood obesity. However, there are scarce data on which parenting practices would be culturally relevant and contribute to lower the risk for childhood obesity among Hispanic families in the United States. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. An electronic database search of records was carried out in PubMed, CINAHL, PsycINFO, and Scopus to synthesize studies assessing associations or intervention effects of parenting practices on child BMI or other anthropometric measure among Hispanic parent-child dyads aged ≥18 and 2-12 years, respectively. Results: Of 1055 unique records identified, 17 studies were included. Most of these studies used a cross-sectional design (n = 10) and child BMI z-scores or BMI-for-age-sex percentiles as the outcome variable. Parenting practices to lower the risk for child overweight/obesity among Hispanic families included setting limits and providing routines (e.g., limited screentime), supporting a healthy lifestyle and physical activity (e.g., providing transportation to places for children's physical activities), and parenting feeding or diet-related practices (e.g., control the foods that children eat). Conclusion: Parenting practices that support healthy behaviors may be components of interventions to lower the risk for childhood obesity among Hispanic families.

Mediterranean Diet Is a Predictor of Progression of Subclinical Atherosclerosis in a Mediterranean Population: The ILERVAS Prospective Cohort Study.

Atherosclerotic cardiovascular disease remains a major health issue, often developing silently as subclinical atherosclerotic disease (SAD). The Mediterranean diet (MDiet) is known for its cardiovascular benefits, but the combined influence of both MDiet adherence and physical activity (PA) on SAD progression has not been previously documented. Objective: We aimed to investigate how adherence to a healthy lifestyle, defined as MDiet adherence and PA level, influences SAD progression in subjects from the ILERVAS cohort follow-up. Methods: A study on 3097 participants from the ILERVAS prospective cohort was conducted. MDiet adherence was assessed using the MEDAS score, and PA categories were established using the IPAQ, both categorized into low, moderate, and high levels. Two different lifestyle scores integrating the MDiet and PA categories were built. The presence of atherosclerotic plaques was assessed by carotid and femoral ultrasound examination. Demographic, clinical, and biochemical data were also obtained. Multivariable linear, logistic, and Poisson regression models adjusted for potential confounders were used to analyze the association between the lifestyle scores and SAD progression, as well as the MDiet and PA as separate variables and number of territories with plaque. Results: A healthier lifestyle score did not show an effect on SAD progression. However, a higher MEDAS score was associated with a 3% decrease in the number of territories with plaque (IRR 0.97, 95% CI 0.96-0.99, p < 0.001), suggesting a protective effect of the adherence to the MDiet. PA did not show a significant association (IRR 1.00, 95% CI 1.00-1.00, p = 0.269). Older age, hypertension, dyslipidemia, smoking, and lower eGFR were associated with SAD progression, while the female sex was protective (IRR 0.67, 95% CI 0.63-0.72, p < 0.001). Conclusions: The findings of this study show that higher adherence to the MDiet is associated with reduced incidence of SAD, indicating its potential role in cardiovascular prevention strategies. Although a higher lifestyle score or physical activity levels did not show any significant effect, promoting the MDiet, alongside managing traditional cardiovascular risk factors, could be an effective public health intervention to prevent atherosclerosis and reduce the burden of cardiovascular disease.

A Study of Hypertension and Fitness of Individuals with Spinal Cord Injury: A Cross-Sectional Study.

Background/Objectives: Individuals with spinal cord injuries have a higher incidence of chronic conditions such as hypertension and cardiovascular diseases due to a sedentary lifestyle and low levels of physical activity caused by their disability. Additionally, their physical fitness levels are lower compared to those without disabilities. This cross-sectional study aimed to investigate the relationship between hypertension and the fitness of individuals with spinal cord injuries in South Korea while considering differences across sexes and spinal cord injury levels. Methods: This study used data for 835 individuals with spinal cord injuries aged 20-64 years who visited the Korea Paralympic Committee fitness standard test centers from 2018 to 2022, obtained from the Korea Culture Information Sports Association's big data market. The data were analyzed using a series of t-tests, a one-way analysis of variance, a logistic regression analysis, and the four-quartile method. Results: The prevalence of hypertension was 24.4%, and it was different according to the spinal cord injury impairment level. A lower grip strength, a lower arm curl, and a higher body mass index were associated with increased blood pressure. Conclusions: Therefore, a high level of physical strength in people with spinal cord injuries is thought to contribute to lowering blood pressure.